Last updated: July 14, 2026
Once a practice implants devices from more than one manufacturer, staff must navigate separate, non-interoperable portals to retrieve patient data. Current remote monitoring platforms for CIEDs differ in technical architecture, data acquisition modalities, transmission systems, and alert algorithms, resulting in variable depth, frequency, and clinical relevance of the information provided. That variability compounds at scale.
CIEDs may fail to transmit data due to technical problems, internet connectivity issues, or being out of range of the transmission device, and distinguishing technical failures from connectivity issues remains difficult. On the alert side, a cross-manufacturer analysis of 2,659 rhythm episodes from 1,710 patients found that 32.9% of episodes from AI-equipped devices were non-actionable. The burden goes beyond operations. As Arnaud Rosier, MD, PhD, electrophysiologist and CEO of Implicity, noted, "When a large share of those alerts are non-actionable, the burden is not just operational, it diverts valuable clinical time from patients who may truly need attention."
The financial consequences are just as significant. A typical 1,000-patient mixed-vendor RPM panel running on each manufacturer's portal, plus manual EHR documentation, often captures only a portion of billable 99454 device-supply months and 99457/99458 management time, leaving substantial revenue uncollected per year. Clinical staff who manually re-enter data across disconnected systems add substantial administrative burden per provider, per day. That burden points to a clear fix: a structured sequence for capturing and validating RPM data before it ever reaches a biller or clinician.
The following steps map the shift from fragmented, single-OEM workflows to a unified, validated, and AI-augmented monitoring environment.
Data integrity and billing compliance depend on each other in cardiac RPM. CPT 93298 covers remote interrogation and monitoring of implantable cardiovascular devices with analysis and physician interpretation. CPT 93299 covers the technical component of that monitoring. CPT 99454 covers device supply with daily recording and programmed alert transmission for a 30-day period, requiring at least 16 days of patient-transmitted data.
The 99454 audit defense requires three artifacts per 30-day period stored as structured database records: a device-status log proving 16 distinct calendar days of transmission, a device-attribution record proving FDA medical device qualification, and a patient-attribution record proving the readings came from the patient under the order. Manual workflows cannot reliably generate all three artifacts at scale, which is why the automated validation and multi-OEM ingestion steps above matter directly to reimbursement.
Rhythm360 automates the documentation chain behind each of these codes. Gaurav A. Upadhyay, MD, at UCM, observed, "We have improved billing and accountability for our patients after the integration." These gains in transmissibility, response time, and revenue capture, outlined earlier, compound as practices scale.
The seven steps above look different depending on how far a practice has already progressed. An honest assessment across three dimensions shows exactly where the gaps are.
| Dimension | Early Stage | Developing | Optimized |
|---|---|---|---|
| Data Accuracy | Manual transcription from OEM portals; no validation layer | Partial API ingestion; some automated flagging | Multi-OEM normalization with AI validation and >99.9% transmissibility |
| Alert Management | All alerts routed to staff inbox; high dismissal burden | Basic threshold filtering; persistent false-positive volume | AI triage with patient-specific baselines; critical events prioritized |
| CPT Capture | Manual billing documentation; frequent claim gaps | Partial automation; some missed 99454 thresholds | Automated artifact generation; full 93298/93299/99454 audit trail |
Practices at the Early Stage typically face the highest revenue leakage and the greatest clinical risk from missed events. The Developing stage reflects partial automation that still leaves real gaps. Optimized practices have closed those gaps by completing the seven steps: unified ingestion, AI triage, and automated billing documentation.
Practices that have invested in monitoring infrastructure can still undermine their own results. These pitfalls often resurface pieces of the earlier steps that were only partially completed.
The questions below address the details practices ask most often once they start planning implementation.
Cellular devices transmit through an embedded SIM with one-button operation and no smartphone, app, or Wi-Fi required. Bluetooth devices need pairing, an app, and proximity within about 30 feet during measurement. As covered above, cellular connectivity generally produces better compliance and billing outcomes for older patients, while Bluetooth suits tech-comfortable patients who face fewer barriers.
AI triage systems build patient-specific baseline profiles from an initial period of per-patient vital sign data. Alerts are then evaluated against each patient's individual rolling mean rather than a population-level cutoff, which cuts non-actionable notifications sharply. Rhythm360's AI triage layer filters noise and prioritizes events such as new-onset AFib, ventricular tachycardia, lead malfunction, and ERI/RRT indicators for immediate clinical review. The platform also offers optional 24/7/365 oversight by certified cardiac technicians supervised by physicians for complex or ambiguous transmissions. The result: an 80% reduction in critical alert response times, letting clinicians shift from reactive to proactive care.
The primary codes are 93298 (remote interrogation and monitoring with physician analysis) and 93299 (the technical component). CPT 99454 covers device supply with daily recording for a 30-day period, requiring transmission on at least 16 days. CPT 99457 and 99458 cover clinical staff time reviewing data and communicating with patients. A transmission gap that keeps a patient under the 16-day threshold eliminates the 99454 claim entirely, which is why Rhythm360 automates the three audit artifacts required per billing period.
Implementation, including EHR integration, typically takes from a few days to a few weeks depending on the EHR system and the complexity of existing workflows. The platform supports bi-directional integration with Epic, Cerner, Athenahealth, eClinicalWorks, Greenway Health, and others via HL7. Once integrated, device transmissions and signed reports populate the clinical chart automatically, and patient demographic and order data from the EHR populate the Rhythm360 dashboard. This removes the administrative burden that disconnected systems impose on clinical staff and ensures every billable event lands in the patient record.
Fragmented OEM portals, manual transcription workflows, and static alert thresholds are not sustainable for cardiology practices managing growing CIED and chronic disease populations. The seven-step sequence outlined here, from cellular device selection and structured onboarding through AI triage, vendor-neutral normalization, bi-directional EHR sync, and real-time performance dashboards, provides a concrete path from data fragmentation to unified, validated, and billable monitoring.
Rhythm360 operationalizes every step of that sequence in a single platform. At the University of Chicago Medicine, Andrew Beaser, MD, noted, "We are able to address these issues earlier; rather than waiting for a 3-month visit, we can call patients in for evaluation." That shift, from scheduled visits to continuous, data-driven intervention, is what accurate RPM data capture makes possible.
The platform scales from solo electrophysiology practices to large integrated health systems without requiring additional OEM portal logins, manual data entry, or separate billing workflows.
